What is not covered
Medicare coverage gaps, listed.
Original Medicare leaves real gaps. Knowing them up front helps you plan — and avoid surprise bills.
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Major gaps in Original Medicare
- Most routine dental, vision, and hearing. Cleanings, glasses, hearing aids — not covered. See our DVH guide.
- Long-term custodial care. Help with daily activities only is not covered. (Long-term care insurance is a separate product.)
- Most overseas care. Original Medicare generally does not cover care outside the U.S. Some Medigap plans add limited foreign travel emergency coverage.
- Cosmetic procedures. Not covered unless medically necessary.
- Most prescription drugs. You need Part D or an Advantage plan with drug coverage.
- Your 20% Part B coinsurance. After your Part B deductible, you owe 20% of approved amounts — uncapped. Medigap or Advantage caps this.
Three ways to fill the gaps
- Medicare Supplement (Medigap). Pays your share of Original Medicare cost. Pair with Part D.
- Medicare Advantage. Replaces Original Medicare and usually bundles in extras like dental, vision, hearing, and drugs.
- Standalone or supplemental coverage. Buy separate dental, vision, hearing, or hospital indemnity policies as needed.
What to budget for
Even with good supplemental coverage, plan for:
- Annual Part B premium (deducted from Social Security if you have it)
- Annual Part B deductible
- Drug deductible and copays
- Out-of-pocket on extras like a new pair of hearing aids
See how much does Medicare cost for the breakdown.